Traction Bronchiectasis/Bronchiolectasis is Associated with Interstitial Lung Abnormality Mortality

Tomoyuki Hida; Mizuki Nishino; Takuya Hino; Junwei Lu; Rachel K Putman; Elias F Gudmundsson; Tetsuro Araki; Vladimir I Valtchinov; Osamu Honda; Masahiro Yanagawa; Yoshitake Yamada; Akinori Hata; Masahiro Jinzaki; Noriyuki Tomiyama; Hiroshi Honda; Raul San Jose Estepar; George R Washko; Takeshi Johkoh; David C Christiani; David A Lynch; Vilmundur Gudnason; Gunnar Gudmundsson; Gary M Hunninghake; Hiroto Hatabu

doi:10.1016/j.ejrad.2020.109073

Traction Bronchiectasis/Bronchiolectasis is Associated with Interstitial Lung Abnormality Mortality

Eur J Radiol. 2020 Aug:129:109073. doi: 10.1016/j.ejrad.2020.109073. Epub 2020 May 18.

Authors

Tomoyuki Hida¹, Mizuki Nishino², Takuya Hino², Junwei Lu³, Rachel K Putman⁴, Elias F Gudmundsson⁵, Tetsuro Araki², Vladimir I Valtchinov², Osamu Honda⁶, Masahiro Yanagawa⁶, Yoshitake Yamada⁷, Akinori Hata⁶, Masahiro Jinzaki⁷, Noriyuki Tomiyama⁶, Hiroshi Honda⁸, Raul San Jose Estepar⁹, George R Washko⁴, Takeshi Johkoh⁶, David C Christiani¹⁰, David A Lynch¹¹, Vilmundur Gudnason¹², Gunnar Gudmundsson¹³, Gary M Hunninghake¹⁴, Hiroto Hatabu¹⁵

Affiliations

¹ Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA; Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Fukuoka 8128582, Japan.
² Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
³ Department of Biostatistics, Harvard TH Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115, USA.
⁴ Pulmonary and Critical Care Division, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
⁵ Icelandic Heart Association, Hjartavernd, Holtasmári 1, 201 Kópavogur, Iceland.
⁶ Department of Radiology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka 5650871, Japan.
⁷ Department of Diagnostic Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 1608582, Japan.
⁸ Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Fukuoka 8128582, Japan.
⁹ Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
¹⁰ Department of Environmental Health, Harvard TH Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115, USA.
¹¹ Department of Radiology, National Jewish Health, 1400 Jackson Street, Denver, CO 80206, USA.
¹² Icelandic Heart Association, Hjartavernd, Holtasmári 1, 201 Kópavogur, Iceland; University of Iceland, Faculty of Medicine, Vatnsmyrarvegur 16, 101 Reykjavík, Iceland.
¹³ University of Iceland, Faculty of Medicine, Vatnsmyrarvegur 16, 101 Reykjavík, Iceland; Department of Respiratory Medicine, Landspitali University Hospital, University of Iceland, Faculty of Medicine, Hringbraut, 101 Reykjavík, Iceland.
¹⁴ Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA; Pulmonary and Critical Care Division, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
¹⁵ Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA. Electronic address: hhatabu@partners.org.

Abstract

Purpose: To investigate if the presence and severity of traction bronchiectasis/bronchiolectasis are associated with poorer survival in subjects with ILA.

Method: The study included 3,594 subjects (378 subjects with ILA and 3,216 subjects without ILA) in AGES-Reykjavik Study. Chest CT scans of 378 subjects with ILA were evaluated for traction bronchiectasis/bronchiolectasis, defined as dilatation of bronchi/bronchioles within areas demonstrating ILA. Traction bronchiectasis/bronchiolectasis Index (TBI) was assigned as: TBI = 0, ILA without traction bronchiectasis/bronchiolectasis: TBI = 1, ILA with bronchiolectasis but without bronchiectasis or architectural distortion: TBI = 2, ILA with mild to moderate traction bronchiectasis: TBI = 3, ILA and severe traction bronchiectasis and/or honeycombing. Overall survival (OS) was compared among the subjects in different TBI groups and those without ILA.

Results: The median OS was 12.93 years (95%CI; 12.67 - 13.43) in the subjects without ILA; 11.95 years (10.03 - not reached) in TBI-0 group; 8.52 years (7.57 - 9.30) in TBI-1 group; 7.63 years (6.09 - 9.10) in TBI-2 group; 5.40 years (1.85 - 5.98) in TBI-3 group. The multivariable Cox models demonstrated significantly shorter OS of TBI-1, TBI-2, and TBI-3 groups compared to subjects without ILA (P < 0.0001), whereas TBI-0 group had no significant OS difference compared to subjects without ILA, after adjusting for age, sex, and smoking status.

Conclusions: The presence and severity of traction bronchiectasis/bronchiolectasis are associated with shorter survival. The traction bronchiectasis/bronchiolectasis is an important contributor to increased mortality among subjects with ILA.

Keywords: Age Gene/Environment Susceptibility-Reykjavik Study; Interstitial lung abnormality; Pulmonary fibrosis; Traction bronchiectasis; Usual interstitial pneumonia.

MeSH terms

Aged
Aged, 80 and over
Bronchiectasis / complications*
Bronchiectasis / diagnostic imaging*
Cohort Studies
Female
Humans
Iceland / epidemiology
Longitudinal Studies
Lung / diagnostic imaging
Lung Diseases, Interstitial / complications*
Lung Diseases, Interstitial / mortality*
Male
Proportional Hazards Models
Severity of Illness Index
Survival Analysis
Tomography, X-Ray Computed / methods*

Abstract

MeSH terms

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